Monday, January 12, 2015

Paying Moms for their Milk - a slippery slope

There is no question that human milk saves human babies. But when a mother cannot produce sufficient milk for her infant, what are the options? Certainly, for the very premature, there has been a bit of a resurgence of nonprofit milk banks, especially HMBANA (Human Milk Banking Association of North America) in the US and Canada. Conceptually, this is for milk sharing and pasteurization to attempt to avoid any disease passage to these most vulnerable infants.

There has also been a resurgence in milk sharing. Again, when between consenting adults, this also can play an important role.

But, as with all things where there is a possibility of profit,  the slippery slope of commercialism comes in. Don't get me wrong - I believe in enterprise. However, when the profit motive slips in to health care and wellness activities, or for purchase of human cells or organs, we have many many additional considerations to explore.

There is another word for when women accept payment for their bodies. And the women involved in this trade are forced into it due to poverty of one sort or another.

When we ask for women to sell their milk when their child is still nursing, we are asking that the the milk, even if there is surplus, be denied to their own child. Conversely, one might say, this may be the only product a poor woman has to sell, and why not allow payment for their careful collection and sharing of excess milk? We pay for the sweat of the brow, shouldn't we pay for other productive work? When a poor person is offered money for something they can spare, especially in this country, where WIC can provides a "substitute" for free for them to feed their infant, offering payment may seem generous.....or coercive.

The heart of the issue to me is one of availability full unbiased information and free choice among choices in a system that is free of fiscal or personal or health system coercion. Unfortunatley, ours is not such a system.

Black Mothers' Breastfeeding Association of Detroit has taken a stand on this. If you would like to know more, please visit: http://blackmothersbreastfeeding.org/2015/01/open-letter-to-medolac-laboratories-from-detroit-mothers/

Miriam

1 comment:

George Kent said...

Hi Miriam –

I welcome these comments as an opportunity to move the discussion forward.

You said, “When we ask for women to sell their milk when their child is still nursing, we are asking that the milk, even if there is surplus, be denied to their own child.” This could happen, and it would be a serious matter. However, Pamela Morrison, another breastfeeding expert, told me:

There could be checks and balances like clinics attached to milk banks attesting to good gain etc. and the nature of breastmilk synthesis being what it is, most women can easily increase their supply to make an ounce or two extra every day over and above what their baby needs - heavens, most women can easily breastfeed twins.

There are risks linked to paying for breastmilk, but relying on altruism though non-payment might not be the best way to deal with them. The risks can be reduced with appropriate monitoring and regulations, with screening of providers.

Rather than simply excluding the option of paying for breastmilk, it is important to weigh the potential benefits against the risk of harm. No one asks farmers or infant formula manufacturers to offer their products for free as a way of ensuring their integrity. Why should women who offer breastmilk for sale be treated differently?

You said “offering payment may seem generous….or coercive” and added:

The heart of the issue to me is one of availability full unbiased information and free choice among choices in a system that is free of fiscal or personal or health system coercion. Unfortunately, ours is not such a system.

I agree on the importance of avoiding coercion. However, as I see it, telling women who appear to be well informed that they must not accept payment for their breastmilk is itself a form of coercion. In its place, measures can be taken minimize the risks, including the provision of relevant information to all parties to the transaction.

Making more breastmilk available to more infants could do a lot of good.

Aloha, George Kent